Minority populations have multiple impediments to proper health care and this disparity is nowhere more meaningful than in cancer prevention and treatment. The overall cancer death rate for African-Americans is greater than for all other ethnic groups and the disparity, measured as the ratio of black:white cancer related mortality, has even worsened from 1979 to 1998 for both males and females. Considering these facts, it is clear that greater efforts are required for minority populations. This effort must include accrual to cancer therapy (CT) and cancer prevention and control (CPC) trials where minority populations are substantially underrepresented, even correcting for relative frequency to Caucasian populations. This proposal aims to establish a mechanism to accrue greater numbers of minority patients onto CT and CPC trials, to involve primary care health care centers in the minority community and to evaluate impediments for the overall process. The specific goals of this proposal are to broaden access to cancer treatment studies for minority populations by entering substantial numbers of minority patients onto NCI approved CT and CPC studies; to increase community practicing physician participation on NCI approved studies; and to transfer new technology to health care providers caring for minority and underserved populations. Additionally, the proposal will study barriers to CPC in minority populations and examine issues in MBCCOP performance for trials including recruitment, accrual and protocol performance. The Meharry Medical College (MMC) Minority-Based Community Clinical Oncology Program (MBCCOP) is based on the dual mission of MMC to 1) educate minority physicians and 2) to treat minority and the underserved populations. MMC will serve as the centerpiece of the MBCCOP based on its active and increasing cancer treatment trials program in the catchment region of Metropolitan Davidson County (MDC) where minority populations make up approximately 33% of the entire population. The CT component of the MBCCOP will be the catchment areas largest multi-physician oncology practice (TN Oncology) already very active in clinical trials research. MBCCOP physicians will constitute 56% of all medical oncologists in the catchment area. These two groups care for large numbers of minority patients in MDC and both have a proven track record for placing patients on NCI approved protocols. MMC has a long and illustrious history in studying health care disparity and improving health care in the minority community. MMC and Vanderbilt University have extensive ongoing CT and CPC research that will serve as a foundation to expand accrual to other NCI approved trials of the research base(s). The CPC component will be an already established consortium of primary care health clinics that focus on minority and the underserved. This "Safety-Net" consortium is directed by a member of the MBCCOP and encourages research and health care delivery. This group of health care clinics, together with a novel and validated method to increase community participation in health care will be used to accrue patients onto CPC studies. The design of the MBCCOP, together with the components and established patient care methods, will allow for substantial numbers of patients to be entered onto CT and CPC studies of the NCI.